Extra-articular obstacles: Secondary muscle shortening due to hip in subluxed/dislocated position Intra-articular obstacles: Results in decreased volume of the acetabulum
Author: Dr. Sulabh Kumar Shrestha, MS Orthopedics
He is the section editor of Orthopedics in Epomedicine. He searches for and share simpler ways to make complicated medical topics simple. He also loves writing poetry, listening and playing music. He is currently pursuing Fellowship in Hip, Pelvi-acetabulum and Arthroplasty at B&B Hospital.
PGMEE, MRCS, USMLE, MBBS, MD/MS
Tonnis and IHDI (International Hip Dysplasia Institute) Classification for DDH
IHDI method is a new radiographic classification of the severity of hip dislocation in DDH. It is based on the location of the midpoint of superior part of ossified metaphysis (H-point) relative to acetabulum. In contrast to Tonnis classification method, IHDI method: Tonnis classification: It is assessed according to the…
Case Reports
Mohr Syndrome (OFD2): An Orthopedic Insight from a Rare Case
Introduction Mohr syndrome, or Orofaciodigital syndrome type II (OFD2), represents a very rare genetic disorder in which there is a triad of craniofacial anomalies, oral malformations, and digital deformities. While classic findings such as lobulated tongue, cleft palate, and broad nasal root mainly remain in the domain of pediatricians and…
Fellowship Blog
When Fixing Bones Meets Nerves: A Lesson from the Cubital Tunnel
Date of writing: June 17, 2025 Day 3 of my pre-fellowship was unlike the others – not because I scrubbed in for an arthroplasty or a hip case (there weren’t any today), but because I witnessed firsthand how a routine trauma case can spiral into an anatomical and surgical challenge….
Fellowship Blog
A New Chapter: Beginning My Fellowship Journey at B&B Hospital
I will be sharing my fellowship journey from my journal here. The posts will be backdated and hopefully I will catchup eventually. Dated: July 15, 2025 As I begin this fellowship training in Hip, Pelvi-Acetabulum, and Arthroplasty at B&B Hospital for one year, I felt like taking a step back…
Blog
Bhandari’s Paradox : Patient’s expectation vs Surgeon’s choice (THR vs HRA)
In displaced femoral neck fractures in elderly, the two main treatment options are – Hemiarthroplasty (HRA) which is quicker, with a lower risk of dislocation and Total hip arthroplasty (THA) which provides superior long-term function and durability. Despite evidence favoring THA in many cases, actual surgical practices often lean heavily…
Surgical Skills
Safe Surgical Dislocation of Hip
Surgical Principles Relevant Course of MFCA Surgical Technique 1. Position: Lateral decubitus 2. Incision and approach: Traditional Kocher-Langebeck (KL) approach or Gibson interval (more anterior interval with posterior retraction of gluteus maximus muscle without violating it) 3. Trochanteric (Digastric slide) osteotomy: 4. Exposure: 5. Z-shaped Capsulotomy: 6. Hip Dislocation: 7….
Surgical Skills
Direct Lateral Approach to Radial Shaft
Position: Elbow flexed 90 degree and forearm in mid-prone Landmarks: Skin incision: Centered over fracture in a straight imaginary line joining lateral epicondyle of humerus and tip of radial styloid Superficial dissection: Subcutaneous tissue and deep fascia are incised along the line of skin incision Deep dissection: Interval is developed…